DR. ANDELYN OLSEN (NPI# 1710477658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710477658 |
| Entity Type | Individual |
| Full Name | DR. ANDELYN OLSEN |
| Credential | DMD |
| Practice Address |
4370 Smiley Rd Las Vegas NV 89115-1808 |
| Practice Telephone | 7026687308 |
| Mailing Telephone | 7026687308 |
| Enumeration Date | 2018-05-16 |
| Last Update Date | 2018-05-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
6540 | NV | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NV | NEVADA STATE DENTAL BOARD | 6540 | 01 |
| DEA CONTROLLED SUBSTANCE | CS22781 | 01 | |
| DEA LICENSE | FO4964854 | 01 |
| Street Address |
4370 SMILEY RD |
| City | LAS VEGAS |
| State | NV |
| Zip Code | 89115-1808 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780951376 | James Edward Holmes Sr. | General Practice | 4370 Smiley Rd, Las Vegas, NV 89115-1808 | 2011-11-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235739392 | Maxima Del Carmen Garcia | Technician | 3580 E Alexander Rd Apt 2016, Las Vegas, NV 89115 | 2020-10-28 |
| 1316555097 | Alma Liz Cuello Gonzalez | Technician | 3735 Gulliver St, Las Vegas, NV 89115 | 2020-07-17 |
| 1689214397 | Reginald Powers | Technician | 3817 N Nellis Blvd, Apt 218, Las Vegas, NV 89115 | 2020-01-10 |
| 1932748779 | Mindworks Mental Health Clinic | Clinic/Center | 3830 Timberlake Dr., Las Vegas, NV 89115 | 2019-12-26 |
| 1982249801 | Limitless Behavioral Services Health LLC | Community/Behavioral Health | 4370 E Craig Rd, Apt 2123, Las Vegas, NV 89115 | 2019-11-14 |
| 1033751102 | Patricia Rangel | Technician | 3125 North Pecos Rd Apt #112, Las Vegas, NV 89115 | 2019-10-10 |
| 1003388471 | Nikera Island | Technician | 9564 Nellis Blvd, Las Vegas, NV 89115 | 2018-12-26 |
| 1295218519 | Craig Duerson | Behavioral Analyst | 3624 Elegant Saint Ct, Las Vegas, NV 89115 | 2018-09-12 |
| 1043719750 | Mary Bernadette Mitchell | Technician | 3715 Hayward Field Rd, Las Vegas, NV 89115 | 2018-02-08 |
| 1689190563 | Brian D Rentie Jr. | Behavior Technician | 4730 E. Craig Rd #2160, Las Vegas, NV 89115 | 2017-08-22 |
| Find all providers in zip 89115 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851901755 | Christian J. Otteson | Dentist | 4750 W Sahara Ave Ste 12, Las Vegas, NV 89102-3559 | 2020-08-05 |
| 1811506082 | Jorge Jimenez-marquez, Dmd, Pllc | Dentist | 110 E Bruner Ave Ste 130, Las Vegas, NV 89183-5700 | 2020-07-23 |
| 1235747643 | Sean Patrick Fitzgibbons | Dentist | 6545 Ditmars St, Las Vegas, NV 89166-8026 | 2020-07-21 |
| 1467079806 | Cristian Omar Sosa | Dentist | 860 S Rancho Dr Ste 3, Las Vegas, NV 89106-3828 | 2020-07-01 |
| 1538786421 | Colette Laree Fuglaar | Dentist | 6974 Walden Park St, Las Vegas, NV 89166-8044 | 2020-06-26 |
| 1083233001 | Flamingo Dental Partners LLC | Dentist | 6680 W Flamingo Rd Ste A, Las Vegas, NV 89103-2189 | 2020-04-09 |
| 1356979603 | Kim Dewayne Kemmerly | Dentist | 5905 W Charleston Blvd Apt 250, Las Vegas, NV 89146-1375 | 2020-03-31 |
| 1730714569 | Gulati Highlands Dentistry, PC | Dentist | 4380 W. Cactus Ave, Suite 100, Las Vegas, NV 89141 | 2020-03-12 |
| 1598396236 | Najand Dental, LLC | Dentist | 8525 Blue Diamond Road Suite #110, Las Vegas, NV 89178 | 2020-01-31 |
| 1831739150 | Vivi Baldwin | Dentist | 7785 N Durango Dr Ste 140, Las Vegas, NV 89131-8002 | 2020-01-15 |
| Find all providers in LAS VEGAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.